Op-Ed: Ease looming doctor shortage with federal boost

UMDNJ-SOM Dean Dr. Thomas Cavalieri welcomes new students in a white coat ceremony in August 2011.

The Resident Physician Shortage Reduction and Graduate Medical Education Accountability Act, sponsored by U.S. Reps. Aaron Schock, R-Ill., and Allyson Y. Schwartz, D-Pa. is good news for medical students, for our state, and for millions of people throughout the country.

This month, in southern New Jersey, the University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine in Stratford welcomes the largest class in its history, and the Cooper Medical School of Rowan University opens the doors to its inaugural class.

Together, the schools are admitting more than 210 first-year student doctors, most of whom are New Jersey residents. These bright and talented individuals will become the newest generation of physicians to serve the future health care needs of our state.

And those future needs are great.

The Association of American Medical Colleges estimates that, by 2020, our country will have 91,500 fewer physicians than needed. A recent report by the New Jersey Council of Teaching Hospitals concludes that, within the next decade, the combination of expanded access to health care and New Jersey's growing — and aging — population will leave our state with 2,800 fewer physicians than required to meet adequately the needs of its residents.

Increasing medical school enrollment is only part of the answer to this looming health care crisis. Before they can practice medicine on their own, medical school graduates must complete between three and seven years of training in graduate medical education (GME) programs. In these GME programs, medical school graduates are placed primarily in hospital-based programs under the eyes of experienced physicians, honing the advanced skills that are demanded of their chosen medical specialties.

While tuition, state support, loans, grants and philanthropy cover most of the cost of undergraduate medical school education, financial support for GME training comes largely from the federal Medicare program. More than a decade ago, the Balanced Budget Act of 1997 put a cap on the number of GME training positions available nationwide.

Despite the physician shortage—and the expansion of existing medical schools, and the opening of new schools throughout the country—GME funding and the number of available residency positions nationwide has remained relatively unchanged since 1997. This portends an untenable situation. Graduating medical students, among the best and the brightest students from our colleges and universities, will see their careers halted simply because there aren't enough residency positions to go around.

If that happens, we will be confronted with a physician shortage on one hand, a large pool of qualified medical school graduates on the other, and no avenue for those students to complete the training that will help alleviate the physician shortage.

The GME reform act currently before Congress addresses the coming physician shortage in a reasonable, fiscally responsible way. It creates 15,000 new graduate medical education slots over five years and insists on accountability by requiring programs that receive additional GME funding to meet specific patient care quality measures.

Research has shown that physicians are more likely to practice in the same geographic area where they complete their GME training. Making more residency positions available in our state will help us to ensure that those training in New Jersey ultimately remain here, delivering needed health care to New Jersey residents for decades to come.